Drug may offer new hope for preventing migraines in kids and teens

For children and teens living with migraine, there may be a new preventive treatment, according to a preliminary study released today, February 26, 2025, that will be presented at the American Academy of Neurology's 77th Annual Meeting taking place April 5–9, 2025, in San Diego and online. Researchers found the drug zonisamide, which has been used to treat seizures, may reduce migraine days in this age group. This study does not prove that zonisamide reduces migraine days; it only shows an association. 

Migraine disease is debilitating and can lead to kids having to miss school and other activities. Currently, there is only one FDA-approved migraine preventative medication for this age group. Our results are encouraging, showing zonisamide may be another option for reducing migraine attacks." 

Anisa Kelley, MD, author, Northwestern University Feinberg School of Medicine, Chicago

For the study, researchers reviewed health records at one institution. They identified 256 children and teens who had been diagnosed with migraine and prescribed preventative zonisamide. Of these participants, 28% had difficult-to-treat migraine, which was defined as having migraine disease unsuccessfully treated with two or more previous medications. Researchers documented the number of headache days per month for each participant both before and after starting zonisamide. 

They then divided participants into three subgroups based on how long they took the medication before a follow-up visit with a physician. The first group followed up in the first month, the second group within two to six months and the third group, after six months. 

For all participants, the median number of headache days per month reduced from 18 to six at the first follow-up visit. When comparing between the groups, the subgroup that followed up within two to six months had the largest reduction with a median decrease of six headache days per month. Kelley noted that the data suggested the drug was most effective after at least two months of use.

The data also suggested that the drug was effective for both those with difficult-to-treat migraine disease and those without.

"It's very exciting that we may have an effective way to treat difficult migraine disease in children and teens, however it's important to note that our study did have limitations," said Kelley. "For instance, our study did not compare people taking the medication to people who did not take the medication. Future studies are needed with control groups to confirm our results."

This study was funded by Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago.